Thursday, August 5, 2010

Sharing the (milk) love

I have been blessed with an abundant supply of breast milk. That is to say, I have too much milk for my baby to consume comfortably and of his free will, and I often wake up in the mornings fairly engorged (or in a bit of a puddle). I also have been experiencing overactive let-down since about week four, which is pretty darn painful for me, and it also makes Daniel fussy.

I am making the best of this situation by expressing my milk for comfort and instead of saving it in my freezer indefinitely, I have decided to donate it. Since I don't have to work outside of our home right now, I don't need to store up a bunch of milk in my freezer for when I return to work. A lot of moms who do return to work, in fact, don't use all of the milk that they have stored because they pump at work for the next day's meals. The freezer stock is used only to supplement the fresh milk supply.

I got interested in milk donation before I was even pregnant, when I learned about human milk banks. The Northwest Mothers Milk Bank is in my part of the country, but it is not yet a fully-functioning milk bank. However, there are hospitals in my area that accept donations, as does the Northwest Mothers Milk Bank. They then ship the milk to the bank in San Jose, CA to be pasteurized, and it is then shipped back to the Northwest to be distributed. As you can imagine, (even without this extra step) processing human milk gets expensive. The processing fee is $3-4.50 per ounce before shipping fees, and this only covers a portion of the costs.

Milk banks pasteurize the human milk they receive, which may compromise some of the components of the milk. (This can be one reason families choose to seek out milk directly from a donor instead of through a milk bank.) However, from what I've read, it seems as though the immunological components of the milk are less affected by pasteurization than the enzymes, so it still has many benefits that infant formula cannot parallel.

For now, I have chosen to donate my milk directly to other families who are in need to cut out the extra expense of a milk bank. I am giving my milk to a mother who has recently adopted a baby and wishes to feed him as much breast milk as she can. I have also begun the screening process for donating to a milk bank, because my good friend Rachel's baby boy Bennett received invaluable human donor milk during his recent stay in the Neonatal Intensive Care Unit (NICU). Their experience inspired me to want to help these babies who are in intensive care. While all babies benefit from breast milk, donated milk is particularly valuable for these little ones when their mothers' milk isn't available (or when it isn't enough). Not all NICUs offer the option of providing donor milk for the babies in their care, but they should!

The idea of milk sharing without the middle-man safeguards of a milk bank can be controversial. La Leche League International has official guidelines on milk sharing, which basically encourages both mothers seeking milk and mothers wanting to donate milk to go through a milk bank. Because breast milk is a bodily fluid, drugs, alcohol, and diseases (including viruses like Hepatitis C and HIV) can be transmitted through it. Many recipients of shared milk will ask the donor mother for milk bank screening paperwork—to prove that she is healthy—before accepting her milk.

Websites like Milk Share exist to provide information about milk sharing and also to connect donors and families wanting milk. This site charges a one-time $20 registration fee to join the mailing list to help cover the costs of maintaining the site. It is illegal to sell human milk so other than that one fee, all of the mothers sharing their milk on that site are doing so free-of-charge. If the milk has to be shipped, usually the recipient covers shipping costs, but hopefully if you are in need you will be able to find a donor close to you!

Why donate milk? I donate my milk for the same reason that I donate my blood: human milk saves lives. Also, pregnant and nursing women are prohibited from donating blood, so why not donate milk if you can? There aren't any needles involved if you do mother-to-mother donation, and if you donate to a milk bank there is only one blood test; you can do it at your convenience, and you will help a baby who is in need. It would be ridiculously expensive for a family to buy enough milk from a milk bank to feed their baby exclusively for 6 months and then up to and beyond a year (as recommended by the American Academy of Pediatrics). There is still a lot of work to be done to increase availability of donor milk for babies of mothers who, for whatever reason, cannot breastfeed them. The World Health Organization (WHO) and United Nations Children's Fund (UNICEF) said it best in their joint statement about milk donation:

"The best food for a baby who cannot be breastfed is milk expressed from the mother's breast or from another healthy mother. The best food for any baby whose own mother's milk is not available is the breast milk of another healthy mother.... Where it is not possible for the biological mother to breast feed, the first alternative, if available, should be the use of human milk from other sources. Human milk banks should be made available in appropriate situations."

If you are a healthy mother of a healthy nursling and you are able to donate milk, please consider it! If you have a freezer stock that's getting close to being 5 months old, consider getting screened so you can donate your milk before it expires. Some moms aren't able to make enough milk for their babies, and a better alternative for these families than using artificial baby formula is using human donor milk. And any breast milk is better than no breast milk.

I hope that in the future, donated human milk will be readily available for all critically ill babies and all families who wish to feed breast milk but are unable to breastfeed.

For more information on human milk banking, check out the Human Milk Banking Association of North America's website. I just heard yesterday about a new documentary coming out soon about milk donation called Prescription Milk. Here is the link to the Facebook fan page. Check it out!

I like the idea of donating to a milk bank, but it has not been a good fit for me. Locally, you have to commit to donating 100 ounces of milk, and you have to do it in your baby's first year. The reasons for this are that the screening process is onerous and expensive, so they need a certain amount of milk to justify it. And your milk needs to be appropriate for the babies who receive it, who are most frequently premature newborns.

I understand the restrictions, but I have never been a great pumper. And so I am not sure that I can make the commitment. And of course, now my nursling is almost 2, so I couldn't donate in any case. It disappoints me, because I like the idea of milk banks and donating to them. But I just can't make that promise and then not follow through.

Thanks for adding your perspective, Amber! The 100 ounces requirement is definitely a prohibitive factor for a lot of moms. I haven't been told that I can't donate when my child is over 1 year old, but he is just 2 months old now, so perhaps that is why it hasn't come up? (Or maybe the requirements are different in Canada?) I just wish it was easier for people to donate, regardless of the volume of milk or the age of their nursling.